Compounding key for some with bladder inflammation

Preparations work when commercial products fail

When Randy Davis, BSPharm, calculated the price of the lidocaine–heparin solution he was preparing for a patient, he was shocked. Because of shortages, a 21-day supply would cost several hundred dollars.

Davis apologized to the woman in advance about the cost and prepared enough solution to get her through the weekend. 

That Friday night, after the patient had catheterized herself and administered her first dose of the medication, she called the pharmacy—thrilled.

“She said, ‘I am so relieved and so thankful. I am thrilled about picking up the rest on Monday. I’m just so excited about it,’” Davis recalls.

The owner of the Wellness Center Pharmacy in Chattanooga, TN, Davis couldn’t believe a patient would be so eager to spend nearly $400 on a drug she’d need to administer for 21 days through a catheter. But for those who suffer from a painful chronic condition that big drug companies have no interest in, relief can be priceless.

Davis’ patient has suffered from interstitial cystitis, a chronic inflammation of the bladder wall, for at least 20 years. After so long, monthly infusions of commercially available drugs at her urologist’s office had become ineffective. The urologist had heard about a compounding pharmacy in another state that made the lidocaine–heparin solution, so he called Wellness Center Pharmacy to see if Davis could compound this preparation.

“I said, ‘Absolutely, but let her know I may not be able to get it to her today.’ But the patient was so excited that she came right over and said, ‘Is it ready?’”

Symptoms of interstitial cystitis include painful urination, pelvic pain, pain during intercourse, and the need to urinate up to 60 times per day.  While the condition can greatly compromise a patient’s quality of life, interstitial cystitis is relatively underrecognized and underdiagnosed, and there is no single treatment that works for most people.

For these reasons, the condition doesn’t draw the attention of commercial drug manufacturers. Many patients must rely on compounding pharmacies such as Davis’s to get the treatment that works for them.

Bladder inflammation isn’t the only rare condition Davis helps treat. Located next door to an eye clinic, Wellness Center Pharmacy sees many patients with severe eye infections that don’t respond to commercial antibiotics. Without compounded drugs, the patients could lose their sight, Davis said.

“If it weren’t for compounding, doctors would just have to give them a diagnosis and say I’m sorry. How would you like to tell someone, ‘I can’t treat you?’ That’s when these urologists and eye doctors call us. And we love helping the patients get better. It’s rewarding.”